Reporter's Notebook: Koch Recuperates His Way

By ALAN FINDER

Published: August 16, 1987

Mayor Koch, who is seldom shy about sharing his thoughts, went to unusual lengths last week to document his feelings and reflections after a three-day hospitalization for a minor stroke.

Mr. Koch wrote a 28-page essay, titled ''An Account of My Recent Illness,'' while he recuperated early in the week at Gracie Mansion. Mr. Koch said he had composed and released the document to help other people learn from his experience - in particular, that they should be quick to seek help at the first sign of illness, as he had.

Only two paragraphs of the narrative, however, discuss that issue. The essay actually concentrates on more familiar mayoral terrain, such as detailed evaluations of his own performance and that of those around him, including how well his doctors did at news conferences broadcast live at which they discussed his medical condition. (Mr. Koch said he had watched the news conferences from his hospital bed.) The Mayor had attended a forum on AIDS just before falling ill on the morning of August 6. He described his participation at the forum this way: ''I was also told that my presentation, with humor and feistiness coupled with an obvious familiarity with the facts, was well received.''

Mr. Koch, in closing his essay, chose this anecdote to sum up his experience: ''Monday night at about 10:30 P.M., a friend called. He said, 'How are you?' I said, 'I'm fine, Charlie.' Then he said: 'It is amazing what happened on Thursday and over the weekend. The entire town shuddered because of what happened to you. They suddenly realized what it would be like if you were not here. You should be very moved by that.' I said, 'I am.' ''

Mr. Koch had praise for others, too. He paused throughout the narrative to note the ''brilliance'' of almost every doctor with whom he came in contact. His strongest, and perhaps most vulnerable, feelings were reserved for a neuroradiologist at Columbia-Presbyterian Medical Center, Dr. Sadek K. Hilal, who comforted the Mayor at a critical moment.

Mr. Koch was being taken to a nuclear magnetic resonance machine in the basement of the medical center's Neurological Institute for sophisticated diagnostic tests, after having twice suffered temporary episodes of dizziness and slurred speech. ''I was helped out of the chair by Dr. Hilal,'' the Mayor wrote, ''and he said to me: 'Eddie, don't worry. You will be okay.' I knew that I would be and I knew I was in special hands.''

''It was nice to have someone talk to me in such a familiar way,'' Mr. Koch continued. ''Up to that point everyone had been referring to me as Mayor or Mr. Mayor. While I realize that that was done out of respect or courtesy, it seemed all too impersonal. I really wanted to be hugged and shielded from harm at that particular moment. Dr. Hilal figuratively hugged me.'' 2 Incidents in Restaurants

All the commentary on the Mayor's health made some people recall the two previous incidents in which Mr. Koch fell ill during his nearly 10 years in office. Once, in 1983, he collapsed while eating in an Italian restaurant on the Upper East Side. His doctor later said the incident was caused by overeating.

Mr. Koch himself recalled the second incident in a chat with reporters in his office on Wednesday, his first day back at work. In 1981, a friend had to perform the Heimlich maneuver to save the Mayor when, as he said Wednesday, ''I choked on what we said was watercress.''

That remark elicited more questions from reporters, who had been hearing for years that it was actually another part of the Chinatown dinner that had nearly done in the Mayor.

''There was a debate as to whether it was watercress or spare ribs,'' Mr. Koch said. ''I said that I wasn't sure, because they were both on the table at the same time and I had said I had eaten both. And a vote was taken and the vote was watercress.'' The Mayor laughed softly. ''So as not to affend some constituents?'' a reporter asked.

''You're right,'' he answered. Fast-Lane Appetites

Can the Mayor slow down, even temporarily? Mr. Koch's staff asked themselves the question last week, as did the Mayor's doctors, reporters at City Hall and, no doubt, many city residents.

Even the Mayor's harshest critics would acknowledge that his energy is legendary and that he devotes long days to his duties, although they might argue about what he actually accomplishes in his 12- and 14-hour workdays.

Mr. Koch's doctors, in releasing him from the hospital, told him to spend last Monday and Tuesday at home. When they allowed him to return to City Hall on Wednesday, they ordered that he work half days for the rest of the week.

The early returns were not encouraging. The Mayor was supposed to rest for two hours each morning and two hours each afternoon during his two-day recuperation at Gracie Mansion. On Monday, Mr. Koch was busy dictating his hospital memoir to his secretary, meeting with deputy mayors and other aides and talking to reporters. He rested, at most, an hour, aides said. The results were not much better the second day.

By Wednesday, though, when Mr. Koch was back in City Hall, he promised to do better at following doctors' orders. He acknowledged that they were concerned, and he said that one of his doctors had telephoned to say that he did not want the Mayor to be a ''wild man.''

''Believe me, '' Mr. Koch told reporters, ''I'm a person who takes advice from physicians and listens to them. I know that I'm very lucky. I came within a hair's breadth of being paralyzed.''

Indications were that the Mayor's behavior was more restrained late in the week. He left City Hall by mid- to late afternoon each day and returned home. He actually slept for an hour in a hammock Thursday afternoon.

Most evenings, Mr. Koch stayed in Gracie Mansion, although he did admit that he had gone out for a while Thursday night to eat dessert (lemon sherbet) at a restaurant on Broadway and to take a walk on Columbus Avenue.

And the much-discussed mayoral diet continued unabated, he reported. The Mayor, who spent the week eating salads, chicken and fish, said he had weighed 216 pounds upon leaving the hospital eight days ago. He also said he weighed 210 pounds Friday morning at Gracie Mansion, which he called ''my naked fighting weight.''

Of course, the true test of a diet can come only by using the same scale over time. Late Friday morning, the Mayor stepped up on a scale at City Hall to inaugurate a diet pool among senior city officials and City Hall reporters. Each participant put up $3, with the pool to go to the person who most quickly loses 10 pounds - and keeps them off for three days.

In the presence of reporters, photographers and television cameras, Mr. Koch stood on the scale that will officially record his progress, as well as that of First Deputy Mayor Stanley Brezenoff, Deputy Mayor Alair A. Townsend and more than a dozen others. The reading: 221 pounds.